摘要目的：探讨分化型甲状腺癌（DTC）肺转移采用放射性碘（131 I）治疗的临床疗效，分析影响疗效的相关因素。方法94例 DTC 肺转移患者于甲状腺癌手术后接受131 I 治疗，结合患者具体情况，首次治疗的131 I 剂量为3．7～7．4GBq（100～200mCi），采用空腹1次口服法。治疗后6个月评价短期疗效。分析年龄、性别、首次131 I 治疗剂量、首次治疗前血清甲状腺球蛋白（Tg）水平以及肺部转移灶特点对131 I 治疗短期疗效的影响。结果94例 DTC 肺转移患者首次131 I 治疗结束后3个月评价短期疗效，治愈29例（30．9％）、好转30例（31．9％）、无效35例（37．2％），有效率62．8％（59／94）。94例患者治疗后均获随访，其中7例出现肺部以外其他器官的新转移灶，3例治疗无效死亡。女性患者疗效优于男性，首次治疗前血清 Tg 水平较低者的疗效优于水平较高者（P ＜0．05）。结论131 I 治疗分化型甲状腺癌肺转移患者有一定疗效，以年龄≤40岁，转移灶直径＜1cm、无合并其他部位转移、首次131 I 治疗前 Tg 水平偏低者131 I 治疗效果较好；而年龄＞40岁、转移灶大、有其他部位转移、首次131 I 治疗前的 Tg 水平高是影响131 I 治疗效果的主要因素。

abstractsObjective To investigate the differentiated thyroid carcinoma (DTC)pulmonary me-tastasis treated with radioactive iodine (131 I)the curative effect,analysis the relevant factors influencing the treatment effect.Methods Ninety -four patients with DTC pulmonary metastasis from thyroid cancer sur-gery after 131 I therapy,combined with the specific situation of the patients,the treatment of 131 for the first time for 3.7 ~7.4 GBq (mCi)100 ~200,using 1 oral medication on an empty stomach.after 6 months e-valuate the short-term curative effect.Analysis on age,gender,131 I treatment dose,for the first time before the first treatment serum thyroglobulin (Tg)levels and characteristics of pulmonary metastases to the effects of short-term curative effect of 131 I treatment.Results Ninety -four patients with DTC pulmonary metasta-sis for the first time after the end of 131 I treatment for 3 months short-term curative effect evaluation,a total of 30 cases cured (31%),29 cases improved (32%),35 cases (37%),effective rate was 63% (59 /94).During follow-up,94 patients with DTC lung turn 7 cases in new organs other than lung metastases,3 cases died.Female patients curative effect was better than that of men,for the first time before preoperative staging.treatment the curative effect of serum Tg level lower than level higher (P <0.05).Conclusions 131 I treatment of differentiated thyroid cancer metastasis has good curative effect,age,size of metastases, presence of other parts of the transfer,for the first time before 131 I treatment of Tg levels are the main factors influencing the effect of 131 I treatment,including age,metastases diameter less than 1 cm,no merger Other parts of the transfer for the first time,lower Tg level before 131 I therapy for patients with 131 I treatment effect is valuable.